An opening snap occurring early in diastole along with a single second heart sound can mimic a split second heart sound.
An opening snap is caused by thickened valve leaflets. When they open, it produces a snapping sound.
The more severe the thickening the earlier in diastole the opening snap occurs. In this example you are hearing an opening snap, which occurs 75 milliseconds after the start of the second heart sound.
Opening Snap and Second Heart Sound Audio
Opening Snap and Second Heart Sound Sounds
Half Speed Opening Snap and Second Heart Sound Sounds
Technique
The patient's position should be supine.
Auscultation Tips for Opening Snap and Second Heart Sound
Diastole:Snap early in diastole, higher-pitch than S2Sound Wave
Opening Snap and Second Heart Sound Video
An opening snap is caused by thickened valve leaflets. When they open it, produces a snapping sound.
The more severe the thickening the earlier in diastole the opening snap occurs. In this example you are hearing an opening snap which occurs 75 milliseconds after the start of the second heart sound.
Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
-
12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language ECG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Sources
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Electrocardiography for Healthcare Professionals, 6th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023 -
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company -
EKG Reference Guide
EKG.Academy -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 - Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
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ECG Reference Guide
PracticalClinicalSkills.com
Opening Snap and Second Heart Sound | #52
